Individual
STEPHEN MARTIN FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1333
AZ
152W00000X
Optometrist
Primary
2368
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021010
KAISER COMMERCIAL NUMBER
CO
01
—
1333
STATE LICENSE
AZ
05
—
90476522
—
CO
Enumeration date
06/26/2006
Last updated
05/20/2021
Update your record
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